SCAN Health Plan, a California-based Medicare Advantage insurer, is pushing further into the world of virtual drug management with an investment in Arine, a software vendor with a focus on artificial intelligence-backed medical management solutions.
On Oct. 19, SCAN Group, the carrier’s parent company, announced it had taken a minority stake in the vendor, with whom it had a previously established client relationship. The investment in Arine, whose software platform relies on predictive analytics to drive medication adherence, gives SCAN the ability to target specific populations and tailor messages individually to members, including to traditionally underserved populations, according to Binoy Bhansali, corporate vice president of corporate development for SCAN Group.
Populations of Color Are Vulnerable
“We have a gap in adherence scores in certain populations,” Bhansali tells AIS Health, a division of MMIT. He points to Black and Latinx communities as those that typically see lower adherence to medication regimens, which can produce poorer health outcomes and increase overall costs of care.
Estimates show that adherence rates to medications aimed at treating chronic disease are only about 50% across the larger population, and those rates may slip as members age. They tend to be lower among minority groups as well. Using the Arine platform allows SCAN to “engage our members in a different way,” Bhansali says. That includes messaging and reminders that are “culturally appropriate” as a way to reduce the risk of patients falling out of step with their plans of care.
Bhansali says that while it’s too early to show definitive quality returns in the data, the indicators are promising. “Early metrics are pointing in the right direction,” he says.
The potential to move the needle is huge. According to statistics from Arine, 20% of older adults are taking inappropriate medications, and medication non-adherence or misuse is responsible for one-third of emergency room visits among the elderly population. To combat the problem, Arine’s software platform “analyzes social, clinical and behavioral data and develops personalized recommendations that enable clinicians to tailor care for patients and their care teams,” according to a press release.
Plans Vie for Virtual Assets
The early quality returns and continued focus on member care are not the only reasons for SCAN’s investment in Arine, Bhansali says. The tech vendor presented a compelling business case on its own.
Taking a minority stake gave SCAN “the financial opportunity for the investment to return money,” he says.
That type of tech-based investing follows a wider industry trend, notes Ashraf Shehata, national sector leader for health care and life sciences at consultancy KPMG. Chronic care management and data-driven medication management have become “a major area of strategic investment,” Shehata tells AIS Health.
Since the start of the COVID-19 pandemic, health plans have been part of “a very heavy investment cycle…to move toward the digital world,” Shehata says.
The working relationship between SCAN and Arine, which moved from a strictly client-based structure to an ownership stake, marks something of a “try-before-you-buy kind of approach,” Shehata adds.
For SCAN, the investment comes as the latest move in the organization’s wider diversification strategy, according to Bhansali. In recent months, SCAN has invested in MedArrive, a partnership focused on in-home care, as well as Monogram Health, a tech-driven vendor that manages and coordinates care of chronic kidney disease. The series of investments fits a pattern of seeking to more directly impact at-risk patients, often those from marginalized groups.
“At a national level, there’s a huge interest in health equity,” Shehata says.
System Aims for Tailored Messages
The scientific community has long identified cultural and racial differences as a key factor in medication adherence rates. A 2019 study appearing in PloS One found that, even when controlling for socioeconomic factors such as income and education, “substantial racial disparities persisted.”
Feeding its AI-driven platform with claims and documentation data, among other inputs, the Arine system delivers tailored messaging to patients that seeks to resonate culturally and linguistically. As the early indicators are showing, the patient-directed messaging can help ensure members are taking the correct medications and staying on them.
The direct financial stake in Arine is likely to provide SCAN the ability to drive, or at least influence, the continued development of the company’s software offerings, which would have the added effect of bolstering the carrier’s direct impact on its members. In other words, SCAN could “request some priority over the investment cycle,” according to Shehata. “If your investment gives you the ability to focus on the needs of your organization, you can do it.”
by Richard Scott
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